Standard 2.01: Do no harm and mandated reporting
RBTs avoid harming their clients and act in their clients' best interest. They know the mandated-reporting requirements that apply to them and follow them.
What it means in practice
Doing no harm starts with safe, accurate implementation: following the plan as written, using its safety procedures, and never adding procedures the plan doesn't include. If something in a session seems to be hurting the client, such as a sharp rise in self-injury, an injury or a procedure the client is in distress over, keep the client safe and contact your supervisor right away.
Mandated-reporting laws vary by state and country, but people who work with children or with vulnerable adults are commonly mandated reporters of suspected abuse or neglect. The standard requires you to know your own obligations and comply with them, so ask your employer what the law requires where you work.
In many places the legal duty to report belongs to the person who has the suspicion. Telling your supervisor is required by the code and your organization's policy, but it may not replace a report the law requires you to make yourself. Report what you saw and heard factually, don't investigate on your own, and document what you did.
Scenarios
| Situation | What to do |
|---|---|
| A child you work with has bruises shaped like fingermarks on both upper arms and says a parent grabbed them hard. | Follow the mandated-reporting law where you work, which typically means reporting to child protective services within the time the law sets. Inform your supervisor according to policy, and document what you observed and the child's words factually. Don't question the child further or confront the parent. |
| During extinction of a client's head-hitting, the behavior becomes so intense that the client cuts their forehead. | Use the safety steps in the plan to protect the client, give first aid and follow injury policy, and contact your supervisor immediately. Document what happened. Do not change the plan on your own; your supervisor decides what comes next. |
| At a group home you notice an adult client has repeatedly been left without lunch, and staff say it's "how things work here". | Treat it as possible neglect of a vulnerable adult. Follow your mandated-reporting obligations, tell your supervisor, follow organization policy and document it (see 2.07). |
Practice questions
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Question 1Why can under-recording a client's self-injurious behavior be especially harmful?
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D: The supervisor may not see how serious it is and may not adjust the plan. Decisions about safety and treatment depend on accurate data. If self-injury looks lower than it is, the supervisor may not adjust the plan, and the client can continue to be harmed.
- A: Recording does not change how often the behavior happens.
- B: Clinical decisions are based on the data, so under-recording affects them directly.
- C: The main harm is a falsely low level, which can delay protective changes to the plan.
Task A.8 · 40-hour curriculum section C · RBT Ethics Code 2.01
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Question 2The safety rules for a functional analysis say to end a session if self-injury causes visible injury. During a session, the client's head hitting causes a cut above the eye. What should the RBT do?
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A: End the session as the safety rules state and tell the supervisor. Functional analyses are run with safety rules set by the supervisor. The client's safety comes first, so the RBT follows the termination rules and reports right away.
- B: Complete data are never more important than the client's safety or the termination rules.
- C: The rules call for ending the session, not continuing it.
- D: Changing conditions on one's own and not reporting an injury both break the protocol.
Task B.3 · 40-hour curriculum section D · RBT Ethics Code 2.01
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Question 3An 8-year-old's plan uses partial physical prompts. Today the child pulls their arm away and says "No touch" each time the RBT starts a physical prompt. What should the RBT do?
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A: Stop the physical prompt, follow any steps the plan gives for this, and contact the supervisor. Pulling away and saying "No touch" signal that the child is withdrawing assent to physical prompts. The RBT stops, follows any plan steps for this situation, and contacts the supervisor for direction instead of forcing the prompt.
- B: Pushing through clear signs that the child does not want to be touched risks harm and ignores the child's withdrawal of assent.
- C: Continuing without checking with the supervisor ignores the child's objection and delays needed direction.
- D: Changing the prompting procedure is the supervisor's decision.
Task C.7 · 40-hour curriculum section E · RBT Ethics Code 2.01 · RBT Ethics Code 2.06
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Question 4An RBT is implementing planned ignoring for a client's whining at a park. While whining, the client starts to walk toward a busy street. What should the RBT do?
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B: Step in to keep the client safe, even though it gives attention. Safety always comes first. An RBT protects the client from harm even if that means delivering some attention, then follows the plan again and reports what happened.
- A: Extinction never overrides safety; a risk of harm must be addressed right away.
- C: This is neither safe nor consistent with the plan; the client must be kept safe directly.
- D: Waiting allows a serious risk of harm, which the RBT must prevent.
Task D.4 · 40-hour curriculum section E · RBT Ethics Code 2.01
Answer every question to see your score.
Where it sits in the code
Standard 2.01 is in section 2, Responsibilities in Providing Behavior-Technician Services, of the RBT Ethics Code (2.0). On the exam it relates to task F.1 Core ethics principles. Read the official text for the exact wording.
Related standards: 2.07 Protecting clients' rights and safety, 2.05 Restrictive and punishment-based procedures, 2.02 Following direction, accurate implementation and documentation.